哮喘-慢阻肺重叠之中医病名初探
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摘要
哮喘和慢阻肺并存的患者临床上并不少见,哮喘-慢阻肺重叠(ACO)是2017全球哮喘防治创议(GINA)更新版中提出的新术语,然中医学上尚未有与之对应的中医病名。通过对哮喘-慢阻肺重叠中医病因、病机、病名的初步探讨,认为本病病因病机特点为哮喘反复发作,久病肺虚,多种病理因素的共同作用下,终致肺气胀满,不能敛降。通过分析古代文献中对"哮喘""慢阻肺""哮喘-慢阻肺重叠"相应病名的描述,建议性地提出将哮喘-慢阻肺重叠归入"哮胀"为妥。
It is not uncommon for patients with asthma and chronic obstructive pulmonary disease to co-exist. Asthma-chronic obstructive pulmonary overlap(ACO) is a new term introduced in the 2017 Global INi tiatve for Asthma(GINA) update. However,Chinese medicine does not yet have a corresponding TCM disease name. In this article,through the preliminary discussion on the cause,pathogenesis,and disease name of ACO,it is believed that the etiology and pathogenesis of the disease is characterized by repeated attacks of asthma,chronic lung disease,and the combined effects of various pathological factors,resulting in fullness and distension in the lung and failure of astringing and descending. By analyzing the corresponding names of asthma,chronic obstructive pulmonary disease,and asthma-chronic obstructive pulmonary overlap in ancient literatures,it is suggested that the overlap between asthma and chronic obstructive pulmonary disease should be classified as "wheezing and distension".
It is not uncommon for patients with asthma and chronic obstructive pulmonary disease to co-exist. Asthma-chronic obstructive pulmonary overlap(ACO) is a new term introduced in the 2017 Global INi tiatve for Asthma(GINA) update. However,Chinese medicine does not yet have a corresponding TCM disease name. In this article,through the preliminary discussion on the cause,pathogenesis,and disease name of ACO,it is believed that the etiology and pathogenesis of the disease is characterized by repeated attacks of asthma,chronic lung disease,and the combined effects of various pathological factors,resulting in fullness and distension in the lung and failure of astringing and descending. By analyzing the corresponding names of asthma,chronic obstructive pulmonary disease,and asthma-chronic obstructive pulmonary overlap in ancient literatures,it is suggested that the overlap between asthma and chronic obstructive pulmonary disease should be classified as "wheezing and distension".
引文
[1]孙永昌.哮喘-慢阻肺重叠综合征指南解读[J].中国呼吸与危重监护杂志,2014,13(4):325-329.
[2]Global strategy for asthma management and prevention[EB/OL].(revised 2014).[2017-05-30].http://www.ginasthma.org
[3]Global strategy for the diagnosis,management,and prevention of chronic obstructive pulmonary disease[EB/OL].(Updated 2014).[2017-05-30].http://www.goldcopd.org.
[4]Global strategy for asthma management and prevention[EB/OL].(updated 2017).[2017-05-30].http://www.ginasthma.org
[5]路明,姚婉贞.支气管哮喘-慢性阻塞性肺疾病重叠综合征研究进展[J].中国实用内科杂志,2015,35(5):379-381.
[6]陈宪海.基于文献整理的肺胀治法评价性研究[D].济南:山东中医药大学,2005.
[7]张秋萍.ACOS中医证候初步观察及阳和平喘颗粒对ACOS非缓解期患者干预作用[D].合肥:安徽中医药大学,2016.
[8]戴广川,朱慧志,胡国俊.胡国俊从虚、瘀论治哮喘-慢阻肺重叠综合征[J].江西中医药,2016,47(12):20,44.
[9]何金波.宣肺通腑法治疗哮喘-慢阻肺重叠综合征的临床硏究[D].成都:成都中医药大学,2016.
[10]陈维志,张治,陈路光,等.化痰活血降气方联合西药治疗哮喘-慢阻肺重叠综合征急性发作期临床观察[J].新中医,2017,49(5):35-37.
[11]汪泳涛,张再良.论《金匮》肺痿、肺胀[J].上海中医药杂志,2000,52(9):41-43.
[2]Global strategy for asthma management and prevention[EB/OL].(revised 2014).[2017-05-30].http://www.ginasthma.org
[3]Global strategy for the diagnosis,management,and prevention of chronic obstructive pulmonary disease[EB/OL].(Updated 2014).[2017-05-30].http://www.goldcopd.org.
[4]Global strategy for asthma management and prevention[EB/OL].(updated 2017).[2017-05-30].http://www.ginasthma.org
[5]路明,姚婉贞.支气管哮喘-慢性阻塞性肺疾病重叠综合征研究进展[J].中国实用内科杂志,2015,35(5):379-381.
[6]陈宪海.基于文献整理的肺胀治法评价性研究[D].济南:山东中医药大学,2005.
[7]张秋萍.ACOS中医证候初步观察及阳和平喘颗粒对ACOS非缓解期患者干预作用[D].合肥:安徽中医药大学,2016.
[8]戴广川,朱慧志,胡国俊.胡国俊从虚、瘀论治哮喘-慢阻肺重叠综合征[J].江西中医药,2016,47(12):20,44.
[9]何金波.宣肺通腑法治疗哮喘-慢阻肺重叠综合征的临床硏究[D].成都:成都中医药大学,2016.
[10]陈维志,张治,陈路光,等.化痰活血降气方联合西药治疗哮喘-慢阻肺重叠综合征急性发作期临床观察[J].新中医,2017,49(5):35-37.
[11]汪泳涛,张再良.论《金匮》肺痿、肺胀[J].上海中医药杂志,2000,52(9):41-43.